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Prevalence of hyperhomocysteinaemia and its major determinants in rural Chinese hypertensive patients aged 45–75 years

  • Yu Wang (a1), Xiaoying Li (a1), Xianhui Qin (a2), Yefeng Cai (a3), Mingli He (a4), Liming Sun (a5), Jianping Li (a6), Yan Zhang (a6), Genfu Tang (a7), Binyan Wang (a2), Ningling Sun (a8), Xin Xu (a9), Lisheng Liu (a10), Xiping Xu (a2) and Yong Huo (a6)...

Abstract

We aimed to investigate the prevalence of hyperhomocysteinaemia (total plasma homocysteine (tHcy) ≥ 10 μmol/l) and its major determinants in rural Chinese hypertensive patients. A cross-sectional investigation was carried out in Lianyungang of Jiangsu province, China. This analysis included 13 946 hypertensive adults. The prevalence of hyperhomocysteinaemia was 51·6 % (42·7 % in women and 65·6 % in men). The OR of hyperhomocysteinaemia were 1·52 (95 % CI 1·39, 1·67) and 2·32 (95 % CI 2·07, 2·61) for participants aged 55–65 and 65–75 v. 45–55 years; 1·27 (95 % CI 1·18, 1·37) for participants with a BMI ≥ 25 v. < 25 kg/m2; 1·14 (95 % CI 1·06, 1·23) for participants with v. without antihypertensive treatment; 1·09 (95 % CI 1·00, 1·18) for residents inland v. coastal; 0·89 (95 % CI 0·82, 0·97) and 0·83 (95 % CI 0·74, 0·92) for participants with moderate and high v. low physical activity levels; 1·54 (95 % CI 1·41, 1·68) and 2·47 (95 % CI 2·17, 2·81) for participants with a glomerular filtration rate 60–90 and < 60 v. ≥ 90 ml/min per 1·73 m2; and 1·20 (95 % CI 1·07, 1·35) and 3·81 (95 % CI 3·33, 4·36) for participants with CT and TT v. CC genotype at methylenetetrahydrofolate reductase 677C>T polymorphism, respectively. Furthermore, higher tHcy concentrations were observed in smokers of both sexes (men: geometric mean 12·1 (interquartile range (IQR) 9·2–14·5) v. 11·9 (IQR 9·3–14·0) μmol/l, P= 0·005; women: geometric mean 10·3 (IQR 8·3–13·0) v. 9·6 (IQR 7·8–11·6) μmol/l, P= 0·010), and only in males with hypertension grade 3 (v. grade 1 or controlled blood pressure) (geometric mean 12·1 (IQR 9·2–14·4) v. 11·7 (IQR 9·2–14·0), P= 0·016) and in male non-drinkers (yes v. no) (geometric mean 12·3 (IQR 9·4–14·8) v. 11·7 (IQR 9·1–13·9), P= 0·014). In conclusion, there was a high prevalence of hyperhomocysteinaemia in Chinese hypertensive adults, particularly in the inlanders, who may benefit greatly from tHcy-lowering strategies, such as folic acid supplementation and lifestyle change.

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Corresponding author

*Corresponding authors: X. Li, fax +86 755 26733079, E-mail: lixy301@gmail.com; Y. Huo, fax +86 10 66530556, E-mail: huoyong@263.net.cn

References

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1Tolonen, H, Mähönen, M, Asplund, K, et al. (2002) Do trends in population levels of blood pressure and other cardiovascular risk factors explain trends in stroke event rates? Comparisons of 15 populations in 9 countries within the WHO MONICA Stroke Project. World Health Organization Monitoring of Trends and Determinants in Cardiovascular Disease. Stroke 33, 23672675.
2Wald, DS, Law, M & Morris, JK (2002) Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis. BMJ 325, 12021206.
3The Homocysteine Studies Collaboration (2002) Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. JAMA 288, 20152022.
4de Ruijter, W, Westendorp, RG, Assendelft, WJ, et al. (2009) Use of Framingham risk score and new biomarkers to predict cardiovascular mortality in older people: population based observational cohort study. BMJ 8, 338–a3083.
5Wang, X, Qin, X, Demirtas, H, et al. (2007) Efficacy of folic acid supplementation in stroke prevention: a meta-analysis. Lancet 369, 18761882.
6Huo, Y, Qin, X, Wang, J, et al. (2012) Efficacy of folic acid supplementation in stroke prevention: new insight from a meta-analysis. Int J Clin Pract 66, 544551.
7Qin, X, Huo, Y, Langman, CB, et al. (2011) Folic acid therapy and cardiovascular disease in ESRD or advanced chronic kidney disease: a meta-analysis. Clin J Am Soc Nephrol 6, 482488.
8Qin, X, Xu, M, Zhang, Y, et al. (2012) Effect of folic acid supplementation on the progression of carotid intima-media thickness: a meta-analysis of randomized controlled trials. Atherosclerosis 222, 307313.
9Holmes, MV, Newcombe, P, Hubacek, JA, et al. (2011) Effect modification by population dietary folate on the association between MTHFR genotype, homocysteine, and stroke risk: a meta-analysis of genetic studies and randomised trials. Lancet 378, 584594.
10Clarke, R, Halsey, J, Lewington, S, et al. (2010) Effects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: meta-analysis of 8 randomized trials involving 37,485 individuals. Arch Intern Med 170, 16221631.
11Refsum, H, Nurk, E, Smith, AD, et al. (2006) The Hordaland Homocysteine Study: a community-based study of homocysteine, its determinants, and associations with disease. J Nutr 136, Suppl. 6, 1731S1740S.
12Sun, Y, Chien, KL, Hsu, HC, et al. (2009) Use of serum homocysteine to predict stroke, coronary heart disease and death in ethnic Chinese. 12-year prospective cohort study. Circ J 73, 14231430.
13Stanger, O, Herrmann, W, Pietrzik, K, et al. (2003) DACH-LIGA homocysteine (German, Austrian and Swiss Homocysteine Society): consensus paper on the rational clinical use of homocysteine, folic acid and B-vitamins in cardiovascular and thrombotic diseases: guidelines and recommendations. Clin Chem Lab Med 41, 13921403.
14McCully, KS (2007) Homocysteine, vitamins, and vascular disease prevention. Am J Clin Nutr 86, 1563S1568S.
15Zhao, D, Liu, J, Wang, W, et al. (2008) Epidemiological transition of stroke in China. Twenty-one-year observational study from the Sino-MONICA-Beijing Project. Stroke 39, 16681674.
16Pezzini, A, Grassi, M, Del Zotto, E, et al. (2006) Interaction of homocysteine and conventional predisposing factors on risk of ischaemic stroke in young people: consistency in phenotype-disease analysis and genotype-disease analysis. J Neurol Neurosurg Psychiatry 77, 11501156.
17Graham, IM, Daly, LE, Refsum, HM, et al. (1997) Plasma homocysteine as a risk factor for vascular disease. The European Concerted Action Project. JAMA 277, 17751781.
18Towfighi, A, Markovic, D & Ovbiagele, B (2010) Pronounced association of elevated serum homocysteine with stroke in subgroups of individuals: a nationwide study. J Neurol Sci 298, 153157.
19Levey, AS, Coresh, J, Greene, T, et al. (2006) Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 145, 247254.
20DuBois, D & DuBois, EF (1916) A formula to estimate the approximate surface area if height and weight be known. Arch Int Med 17, 863871.
21Qin, X, Li, J, Cui, Y, et al. (2012) Effect of folic acid intervention on the change of serum folate level in hypertensive Chinese adults: do methylenetetrahydrofolate reductase and methionine synthase gene polymorphisms affect therapeutic responses? Pharmacogenet Genomics 22, 421428.
22Qin, X, Li, J, Cui, Y, et al. (2012) MTHFR C677T and MTR A2756G polymorphisms and the homocysteine lowering efficacy of different doses of folic acid in hypertensives Chinese adults. Nutr J 11, 2.
23Hao, L, Ma, J, Zhu, J, et al. (2007) High prevalence of hyperhomocysteinemia in Chinese adults is associated with low folate, vitamin B-12, and vitamin B-6 status. J Nutr 137, 407413.
24Jacques, PF, Bostom, AG, Wilson, PWF, et al. (2001) Determinants of plasma total homocysteine concentration in the Framinghan Offspring cohort. Am J Clin Nutr 73, 613621.
25Ganji, V & Kafai, MR (2003) Demographic, health, lifestyle, and blood vitamin determinants of serum total homocysteine concentrations in the third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr 77, 826833.
26de Bree, A, Verschuren, WM, Blom, HJ, et al. (2001) Lifestyle factors and plasma homocysteine concentrations in a general population sample. Am J Epidemiol 154, 150154.
27Lee, CD, Folsom, AR & Blair, SN (2003) Physical activity and stroke risk: a meta-analysis. Stroke 34, 24752481.
28Amouzou, EK, Chabi, NW, Adjalla, CE, et al. (2004) High prevalence of hyperhomocysteinemia related to folate deficiency and the 677C → T mutation of the gene encoding methylenetetrahydrofolate reductase in coastal West Africa. Am J Clin Nutr 79, 619624.
29Craig, SA (2004) Betaine in human nutrition. Am J Clin Nutr 80, 539549.
30Vogiatzoglou, A, Smith, AD, Nurk, E, et al. (2009) Dietary sources of vitamin B-12 and their association with plasma vitamin B-12 concentrations in the general population: the Hordaland Homocysteine Study. Am J Clin Nutr 89, 10781087.
31Poduri, A, Kaur, J, Thakur, JS, et al. (2008) Effect of ACE inhibitors and beta-blockers on homocysteine levels in essential hypertension. J Hum Hypertens 22, 289294.
32Westphal, S, Rading, A, Luley, C, et al. (2003) Antihypertensive treatment and homocysteine concentrations. Metabolism 52, 261263.
33Hustad, S, Midttun, Ø, Schneede, J, et al. (2007) The methylenetetrahydrofolate reductase 677C → T polymorphism as a modulator of a B vitamin network with major effects on homocysteine metabolism. Am J Hum Genet 80, 846855.
34Papoutsakis, C, Yiannakouris, N, Manios, Y, et al. (2006) The effect of MTHFR(C677T) genotype on plasma homocysteine concentrations in healthy children is influenced by gender. Eur J Clin Nutr 60, 155162.
35Russo, GT, Friso, S, Jacques, PF, et al. (2003) Age and gender affect the relation between methylenetetrahydrofolate reductase C677T genotype and fasting plasma homocysteine concentrations in the Framingham Offspring Study Cohort. J Nutr 133, 34163421.
36Wilcken, B, Bamforth, F, Li, Z, et al. (2003) Geographical and ethnic variation of the 677C>T allele of 5,10 methylenetetrahydrofolate reductase (MTHFR): findings from over 7000 newborns from 16 areas world wide. J Med Genet 40, 619625.
37Kjeldsen, SE, Julius, S, Hedner, T, et al. (2001) Stroke is more common than myocardial infarction in hypertension: analysis based on 11 major randomized intervention trials. Blood Press 10, 190192.

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Prevalence of hyperhomocysteinaemia and its major determinants in rural Chinese hypertensive patients aged 45–75 years

  • Yu Wang (a1), Xiaoying Li (a1), Xianhui Qin (a2), Yefeng Cai (a3), Mingli He (a4), Liming Sun (a5), Jianping Li (a6), Yan Zhang (a6), Genfu Tang (a7), Binyan Wang (a2), Ningling Sun (a8), Xin Xu (a9), Lisheng Liu (a10), Xiping Xu (a2) and Yong Huo (a6)...

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